Table of Contents

Trauma Symptoms:

Re-experiencing	Repeated, intrusive, and unwanted memories, nightmares, flashbacks
Avoidance	Persistently staying clear of trauma memories and reminders – people, places, sights, smells, sounds, music
Changes in thinking or emotions	Overly negative beliefs about self, others, world, exaggerated blame of self or others, difficulty experiencing positive mood, isolating
Changes in arousal or reactivity	Overly alert, easily startled, on guard, difficulty concentrating or sleeping, irritability or aggression, risky behavior

Associated concerns: anxiety, mood problems, addictions. The criteria above is for six years and older – there is a subtype for preschool aged PTSD diagnosis

How does PTSD develop?: Many people experience traumas without developing PTSD. A key factor in developing PTSD after a trauma is avoidance. Avoiding people, places, memories, thoughts, and feelings are all reasonable responses to a painful event. Unfortunately, these patterns of avoidance interfere in people learning how to manage emotions, behaviors, and relationships. It is common for people with PTSD to develop negative beliefs due to both the traumatic event in itself and due to the lifestyle of avoidance. Types of negative beliefs that develop may be about oneself, others, emotions, or the world. As avoidance continues, these negative beliefs grow stronger because the person doesn’t get new, corrective information about themselves, others, emotions, or the world. PTSD symptoms become more severe and difficult to overcome.

Trauma Treatment:

Trauma quote: the cure for pain is in the pain

What is the best treatment for trauma: Prolonged Exposure (PE) is the leading evidence- based therapy to treat trauma. DBT-PE is adapted from PE and used to treat trauma in combination with suicidal/self-harming symptoms and multiple diagnoses (i.e., PTSD and BPD).

When should you seek treatment for trauma: the PTSD symptoms have lasted for more than a month and are interfering in a variety of ways. Avoidance is a key symptom in PTSD and can lead to more depression, shame, and anxiety if untreated.

How long can trauma therapy last: DBT-PE and PE can be completed in 12-16 sessions on average. Where there are multiple traumas, research shows that a person can reduce PTSD by completing therapy on 1-3 traumas.

How does trauma treatment work?: There are two specific types of avoidance that occur after a trauma. One type of avoidance is of reminders or cues in the environment related to the trauma (people, places, smells, sounds). The other type of avoidance is of the trauma story (the memories, feelings, thoughts).

DBT-PE uses in-vivo exposure to help clients approach the trauma reminders in the environment that are creating misery in life, and the person wants to stop avoiding. Imaginal exposure is used to revisit the trauma story in a safe environment. These exposure practices can seem very scary, and they are highly effective in teaching people to cope with the trauma reminders that are likely naturally occurring in one’s life, as well as feel in control of emotions, and reduce problem thoughts.

After exposure practices each week, the therapist and client explore what was learned. The goal of this processing is to gain new learning that breaks down old trauma beliefs that are interfering in life, to reduce anxiety, to build mastery over emotions, and to get freedom from suffering!

DBT-PE trained at Wise Mind Counseling: Kim has advanced training in DBT-PE from the creator of the treatment, Dr. Melanie Harned. Kim also participates in ongoing training and consultations to increase competency and to provide the most effective trauma treatment.

Resources for PTSD and Trauma:

DBT-PE
National Center for PTSD – VA
How to prevent trauma from becoming PTSD
Talking to children and teens after a school shooting
How to treat nightmares with PTSD
Apps: PTSD Coach, PE Coach

Why Start Trauma Therapy Today:

It can be life threatening when untreated- 30% of individuals with PTSD attempt suicide.
Untreated trauma further increases the risk of life threatening concerns. Adding the DBT PE protocol to DBT is likely to decrease the risk of suicidal and self-injurious behaviors.
DBT-PE is a very safe therapy and has been proven to be effective at reducing emotional distress.
American Psychological Association says “untreated PTSD from any trauma is unlikely to disappear and can contribute to chronic pain, depression, drug and alcohol abuse and sleep problems that impede a person’s ability to work and interact with others.
Treatment can help prevent other trauma symptoms, including pandemic PTSD.
Among those that have completed DBT-PE, recovery rates were 60-100% across people with multiple diagnoses and problems.
Data shows that people prefer DBT-PE versus DBT or PE alone.